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Dr. Barry Eppley

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Surgeon Dr. Barry Eppley

Posts Tagged ‘vampire facelift’

Injectable Facial Rejuvenation with Platelet-Rich Plasma (PRP)

Sunday, October 4th, 2015


PRP (platelet-rich plasma) has earned a role in a variety of facial rejuvenation procedures. One of its most well recognized uses due to social media and marketing is in the Vampire Facelift procedure. Its name is an obvious spinoff of the use of PRP which requires a blood draw to create the platelet concentrate. It is not a pure PRP procedure as it requires the use of injectable fillers to create the facial volume needed. In theory the PRP acts as a stimulant for soft tissue rejuvenation with its own growth factors and other stimulants…although that is far from proven science.

PRP injectable facial rejuvenation is an all natural treatment. There is no chance of allergic reactions or fear of foreign body interactions in response to these plasma concentrate injections. But what it is not is a facelift by any definition of this procedure. It does not reshape, tighten or otherwise involve removal of loose or sagging tissues as a traditional facelift does. Conversely it is a plumping procedure by adding volume through the use of the combination of PRP and hyaluronic acid-based fillers. The plumping helps stretch out some wrinkles and creates a bit of a tissue lift in some facial areas.

Platelet Rich Plasma injections Indianapolis Dr Barry EppleyWhile PRP is known for its healing properties, its success in causing cell stimulation and rejuvenation in normal people to help ‘reverse’ or treat aging tissues is more speculative. Stimulating tissue repair in injured tissues is one thing, making the body create new cells to treat otherwise normal tissues, albeit aging ones, is more of a biologic stretch. But this is the contention of the Vampire Facelift approach. Inject PRP under the skin and the body takes it from there presumably generating new collagen from stimulated fibroblasts.

There is no question that these injection treatments are safe as they involve PRP and other well known injectable fillers. There is very little possibility of any untoward reactions and complications. It is just a question of how much skin benefit is obtained from injecting the plasma and platelets and whether it provides any longevity benefit to the hyaluronic acid fillers that are also simultaneously placed.

The injection procedure does create some mild bruising and swelling for a few days that, at its worst, completely resolves within a week after the procedure. With the use of blunt injection cannulas, the creation of bruising is virtually eliminated. The effects of volume addition are seen immediately, any tissue stimulation occurs much later. (weeks to months) Whatever tissue stimulation and growth that may occur from the injections is not known how well or long it will persist. There is no question that repeated treatments produce better results. Stacking two to four treatments several months apart will create the optimal facial rejuvenative effect.

Dr. Barry Eppley

Indianapolis, Indiana

The Stem Cell Facelift Revealed

Sunday, April 28th, 2013


Many treatments have been touted over the years to create a facelift-like effect from topical creams to devices in lieu of having the actual surgical procedure. Today’s ‘alternative facelifts’ have taken on a very different approach and it is done through largely an injectable approach. These are all about adding volume to the face, plumping it out in select sunken facial areas. In many ways these are facial reinflation methods which work best for those patients who have lost volume and have a little loose or saggy skin.

These volumetric facelifts are comprised of two basic approaches. The first is the generic liquid facelift which completely uses synthetic injectable fillers and promises nothing more than a limited time period of benefit. The now more appealing, and the group that has caught the most press and is also heavily marketed, is the autologous injection techniques which promise more than just a short-term effect…they promise a rejuvenation of tissues as well.

These autologous injection techniques use either blood products such as platelet-rich plasma (PRP, e.g., the Vampire Facelift) or one ‘s own fat which is obtained by liposuction. Because our fat stores are now known to contain large amounts of stem cells, these type of liposuctioned-derived injections have become known as ‘stem cell facelifts‘. They have become heavily touted on the internet and many patient testimonials as to their rejuvenative benefits can be found online.

But what is a stem cell facelift actually? In reality, it is a bit of a misnomer. It starts with liposuction to harvest fat, usually from the abdomen, which is then processed during the procedure to get rid of most of its fluid contents. (blood, tumescent fluid, free fatty liquids) What happens next varies by the doctor doing it. Some will proceed to inject the fat concentrate while others may further process the fat to obtain a greater cellular concentrate of the material which presumably has more stem cells per injected volume.

For those just taking concentrated fat and injecting it (aka fat injections), any stem cells that are in the fat are inadvertently carried along with it. How many stem cells and how active they are after being injected into the face is anyone’s guess. This is a stem cell facelift in the loosest use of the term.

To those who do a stem cell preparation step with the fat (usually a mechanical process that separates the stem cells from the fat and then they are injected along with the fat), this is a purer form of a stem cell facelift. Such higher concentrations of stem cells are purported to induce skin rejuvenation allegedly because of the growth factors that are produced by the stem cells. But no one really knows for sure.

While the appeal of the stem cell facelift is undeniable, does it really work? The regenerative properties of adult stem cells has been vigorously studied for decades in a  wide variety of medical conditions. But their use in aesthetic medicine is very new and, as a result, the medical evidence supporting their effectiveness is presently very weak. The marketing claims are high, but almost all the clinical evidence of its effectivenss is anectodal….and very short-term.

To really answer the question of the effectiveness of stem cell facelifts, split-face clinical studies would have to be done. Patients would have to submit to one-half of their face being injected with fat and the other half with fat that contained concentrated stem cells with postoperative assessment of appearance and skin improvement. Such studies are hard to conduct although patient recruitment would likely not be difficult.

Stem cells have a lot of regenerative potential but whether that applies to aesthetic conditions like facial aging remains to be seen. I like the concept very much but it remains a clinical procedure that is in the earliest stages of development. And as often happens in many developing aesthetic techniques, the marketing and promotion of it gets way ahead of the actual science to support it.

Dr. Barry Eppley

Indianapolis, Indiana

Injectable Facial Rejuvenation

Tuesday, July 10th, 2012

The desire to correct an aging facial appearance has been around as along as there is recorded history. Facelift surgery in various forms has been employed now for over one hundred years. Today’s facelift techniques are very diverse and use manipulations of all tissue levels down to the bone to achieve often dramatic improvements. Younger patients with very early signs of aging enjoy the benefits of facelifting albeit with more limited procedures geared towards the need for less dramatic changes.

But no matter how it is done, a facelift procedure is invasive and many patients want to avoid surgery if at all possible. Some patients are so opposed to surgery that they will choose any procedure  that simply isn’t surgery. With the widespread and growing use of injectable fillers and promising autologous therapies like platelet-rich plasma (PRP) and stem cells, newer methods of ‘non-surgical facelifts’ have emerged. Some of these have very catchy names and good marketing efforts behind them, which combined with the ability to do them outside of a traditional operating room setting, has caught the attention and imagination of people concerned about their aging facial appearance.

The basic concept of all of these techniques is that they are injectable. While the name ‘facelift’ has become attached them, this is not an accurate name for them. They do not achieve the same effect as a facelift nor should they be construed as having much other similarity to a facelift either. Their use of the facelift name is a marketing manuever. The only similarity between a true facelift and these injection techniques is that they treat the same problem…facial aging concerns. Therefore, the proper name for them should be Injectable Facial Rejuvenation (IFR) which signifies their non-surgical nature They may provide some degree of rejuvenation but they definitely don’t lift tissues in the conventional sense.

In reviewing the available options for Injectable Facial Rejuvenation, it is important to recognize that most of them are not standardized treatment methods and are not sanctioned by the FDA to be used in this fashion. Because these techniques have emerged largely from marketing and patient recruitment means, and not from scientific or clinical studies, there is no way to compare their effectiveness other than anectodal reports and patient testimonials. This is why how one practitioner performs one injectable technique may be different than another. Such provider variability makes it impossible to assess the effectiveness of one IFR method, let alone if one IFR method is more effective than another.

The Liquid Facelift uses either one or a variety of off-the-shelf FDA-approved injectable fillers. These could include any of the many hyaluronic-acid based fillers, such as Restylane or Juvederm, or the particulated fillers such as Sculptra or Radiesse. The concept is the select placement of them into volume-deficient or sagging facial areas that expands them, thus creating some degree of a lifting effect. This is more expansion than a lifting result. Its effects will subside as the filler absorbs. It is postulated but not proven that these fillers have a long-term collagen stimulatory effect.

The Vampire Facelift is the ultimate marketer in IFR because it is a company that sells its technique for use. Its foundation is the use of platelet-rich plasma (PRP), an autologous platelet concentrate extract which contains growth factors and cytokines. Such factors have proven laboratory performance of accelerated healing. When introduced under the skin, it is presumed that it may have some rejuvenative or stimulatory properties. This technique is also combined with injectable fillers. The theory is that the PRP and the fillers in combination may lead to an enhanced and sustained collagen response. Whether this is enough to wake up the living dead is speculative.

The Stem Cell Facelift primarily employs the injection of fat or allegedly concentrated extracts of stem cells. Stem cells have caught the imagination of the cosmetic surgery world with the belief that they will provide some rejuvenative effect. This concept is theoretically appealing but has little scientific proof that this really occurs. Most ‘stem cell extracts’ are just concentrated fat from liposuction harvests. As such, it is impossible to know how many stem cells and what their potential is in any fat concentrate. Because of the widespread uncertainty of the value and effectiveness of stem cells, the American Society of Plastic Surgeons has issued a position statement that any of its members promoting or marketing stem cell techniques as unethical behavior. In addition, the FDA has recently issued a ban on any company that grows patient stem cells for treatment. All stem cell therapies, even using the patient’s own stem cells, must be done under a clinical study protocol. This does not exclude the common use of fat injections in which stem cells exist amongst the fat cells and are incidentally injected. But promoting it as a stem cell procedure is not viewed favorably.

The Acupuncture Facelift employs the traditional Chinese technique of the introduction of needles to free up chi or energy. Allegedly, introducing needles into the face causes the production of collagen and elastin to plump up the skin. After a series of 10 treatments, wrinkles and deeper lines are purportedly reduced and skin is lifted. More likely, some mild swelling occurs as a result of the needles and results in some slight temporary skin fullness but no documented and proven lifting effect that is sustained as ever been studied or proven. This limited injection or needle approach to facial rejuvenation is the greatest stretch in calling it a facelift technique.

Injectable Facial Rejuvenation has a role to play in treating facial aging concerns but should be understood in proper context. They are not facelifts and will not lift up sagging facial tissues. They are principally plumpers or volumizers and achieve any wrinkle or fold reduction through this effect.

Dr. Barry Eppley

Indianapolis, Indiana

Product Reviews: The Vampire Facelift

Friday, March 4th, 2011

One new interesting, but unusually named, cosmetic procedure is that of the “Vampire Facelift.” In truth, it is not really a facelift nor is it used by vampires or will make you look like one. The  Vampire Facelift is far less scary and has much more science to it than most science fiction tales. It is based on the more well known and highly popular injectable filler concept.


It works by injecting its magical potion underneath the skin, much like its manmade counterparts such as Juvederm or Radiesse. But instead of using a prepackaged synthetic material, the Vampire Facelift (trademarked name by the company Selphyl) uses the patient’s own blood to make the injectable filler. A small amount of blood is first extracted from the patient. Then a device separates the platelet portion from the red blood cells. The concentrated platelets are then combined with the company’s  proprietary synthetic mixture and the composite is now ready for injection. The entire preparation process takes less than ten minutes to complete and can be done in an office setting.


The principle of this approach is that platelets are heavily endowed with growth factors. These potent little growth stimulants can induce the growth of new collagen. Collagen, of course, is what gives skin its fullness and suppleness. The implantation of a concentrated platelet mixture could help rejuvenate thin and aging tissues and overlying skin…in theory. It is also appealing to patients in that it is an organic approach to rejuvenation using one’s own tissues to help repair itself.


While this cosmetic application of a platelet concentrate is new, the concept is not. PRP (platelet-rich plasma) concentrates have enjoyed widespread use in healthcare in the past decade, particular in orthopedic and musculoskeletal medicine. Numerous companies have PRP technology and application devices. What makes Selphy unique is that they have made a more simple in-office device at a low cost, which are the requirements needed if cosmetic use will gain any popularity.


While the Vampire facelift (perhaps better understood as a PRP filler) treatment sounds intriguing, it is not known if it will last any longer than that of off-the-shelf injectable fillers. The theory is biologically appealing but whether it actually works has not been conclusively shown. I commonly mix PRP concentrates with fat injections with the theory that the platelets may stimulate better fat preservation or stem cell conversion into adipocytes and/or fibroblasts. This is employing the identical approach but with a different substrate. Time will tell if these biologic injectable mixtures will live up to their theoretical benefits.  


Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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